Effect of Amoxicillin/Clavulanate on Gastrointestinal Motility in Children

Gomez R et al. – In children, administration of amoxicillin/clavulanate (A/C) directly into the small bowel before a meal induces phase III–type contractions in the duodenum, with characteristics similar to those present in the fasting state. These data suggest the possible use of A/C as a prokinetic agent. Further studies are needed to clarify its specific mechanism of action and the group of patients most likely to benefit from its use.

Methods

• Twenty consecutive pediatric patients referred for antroduodenal manometry received 20mg/kg of A/C into the small bowel lumen.
• In 10 patients (group A), A/C was given 1hour after and in 10 (group B), 1hour before ingestion of a meal. Characteristics of the migrating motor complex, including presence, frequency, amplitude, and propagation of duodenal phase III and phase I duration and phase II motility index (MI), were evaluated 30minutes before and after A/C administration.

Results

• There were no statistically significant differences in age and sex between the 2 groups.
• Manometry studies were considered normal in 8 patients in each group.
• In group A, 2 patients developed duodenal phase III after receiving A/C, and no significant difference was found in the MI before and after the drug administration.
• In group B, 9 patients developed duodenal phase III (P<0.05 vs group A).
• All phase III occurred within a few minutes from the medication administration.
• Most duodenal phase III contractions were preceded by an antral component during fasting but never after the medication was administered in either of the 2 groups (P<0.001 vs fasting).
• In group B, the duration of duodenal phase I was shorter after drug administration (P<0.05).
• There was no significant difference in duodenal phase II MI before and after A/C administration for the 2 study groups.

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